CBGD or MSA

I have been diagnosed with CBGD.  But I have autonomic system symptoms, too---nausea, some vomiting, low blood pressure causes dizziness, some respiratory/breathing problems and weakness.  Should  ask my doctors to look into the possibility of MSA?

Thank you.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

There is a group of disorders known as the parkinson's plus syndromes that share in common the presence of some features of parkinson's disease, but with other findings on history and examination that distinguishes them. Often, there are relatively clear-cut findings that allow for the diagnosis of one disorder or another, but in other cases, there is some overlap, and reconsideration of the diagnosis may occur as other symptoms emerge.

Some features that support the diagnosis of CBGD is asymmetric involvement (one side of the body as compared to the other) with dystonia, dyspraxia (inability to use the limb), and alien-limb phenomena. Other features, such as eye movement abnormalities, cognitive (memory, thinking) problems, and problems with speech and swallowing occur, but also occur in the other PD plus syndromes.

As you mention, breathing problems including stridor and autonomic dysfunction are a prominent feature of some one type of MSA, but other parkinson's plus disorders include autonomic dysfunction and breathing problems as well. Evaluation for autonomic dysfunction may not necessarily change the diagnosis, but would be important in case treatments can be instituted to help improve blood pressure fluctuations and/or symptoms, such as compression stockings, dietary salt, and in some cases medications. Evaluation for other causes of autonomic dysfunction (such as diabetes etc) may be indicated if there is evidence by history or examination that one may be present. Similarly, evaluation for laryngeal problems would be important if there is breathing difficulty, particularly stridor.

Discussion of your symptoms and concerns with your neurologist is recommended. Evaluation by a movement disorders specialist (a neurologist with expertise in movement disorders) is recommended.

Thank you for using the forum I hope you find this information useful good luck.